Full-endoscopic surgery for gunshot penetrating wound of the lumbar spine (literature review and clinical case)

2018 ◽  
Vol 20 (2) ◽  
pp. 66-73
Author(s):  
M. N. Kravtsov ◽  
S. A. Landik ◽  
A. А. Dubinin ◽  
K. S. Azatyan ◽  
В. V. Gaidar ◽  
...  

The study objectiveis to determine the feasibility and effectiveness evaluation of full-endoscopic surgery in gunshot wound of the lumbar spine.Materials and methods.A clinical case of a 24-year-old male who received a gunshot wound to the lumbar spine is described. The patient underwent a full-endoscopic intervention aimed at extracting a bullet from the spinal canal.Results.Minimal-invasive approach to spinal canal with the possibility to extract a bullet, decompression of nerve roots, defect closure of the dura mater is demonstrated.Conclusion.Good clinical outcome allows to recommend the full-endoscopic surgery with similar gunshot wounds of the lumbar spine at the stage of specialized care.

2021 ◽  
Vol 23 (2) ◽  
pp. 91-98
Author(s):  
Gennady G. Bulyschenko ◽  
Alexey I. Gayvoronsky ◽  
Pavel S. Liev ◽  
Mikhail V. Kuznetsov ◽  
Dmitry V. Svistov

A clinical case of treatment of a patient with long-term consequences of a gunshot wound to the lumbar spine with a follow-up period of fifteen years is presented. In the last year and a half, the repeatedly recurrent retroperitoneal phlegmon associated with a foreign body of the lumbar spine has prompted a decision on the issue of surgical treatment (removal of a foreign body - a bullet). The location of the foreign body and previous experience with endoscopic foreign body removal played a decisive role in the choice of surgical tactics. Removal of the wounding projectile was performed using a percutaneous transforaminal endoscopic approach. The choice of such an approach was dictated by the peculiarity of the location of the foreign body (coaxial with the endoscopic tube in the foraminal approach), as well as sufficient experience in using the technique of percutaneous endoscopic surgery. At the same time, the conversion plan was worked out in sufficient detail with both posterolateral and anterior open approaches with the involvement of appropriate specialists. So, in case of failure, it was planned to transfer endoscopic access to open, using the already installed working tube of the endoscope as a conductor to a foreign body. In case of inefficiency, for some reason, this version of the operation was planned for the next, third stage: wound suturing, patient turning on the back with a right-hand retroperitoneal approach to the anterior-lateral surface of LI and LII bodies. Fortunately, the purpose of the operation was achieved using the most gentle version of the allowance. The given clinical case testifies that the technique of percutaneous transforaminal endoscopic surgery is not limited in indications to the treatment of degenerative-dystrophic diseases of the spine.


2017 ◽  
Vol 8 (1) ◽  
pp. 290
Author(s):  
Philippe Schucht ◽  
Andrea Bodmer ◽  
Steffen Ross ◽  
Andreas Raabe ◽  
Jürgen Beck ◽  
...  

2020 ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei LI ◽  
Keqin Hua ◽  
Yisong Chen

Abstract Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus ≥ 1 kilogram (kg). Methods: From January 2019 to March 2020, 39 patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patient demographics, indications for surgery, operation outcomes and patient follow-up details were recorded.Results: The mean age was 48 years (range 42-66); the mean BMI was 24 kg/m 2 (range 18.4-38); the mean operating time was 123.3 minutes (rang 40-400), mean estimated blood loss was 206.7 milliliters (range 10-1300); the mean uterus weight was 1141.8 gram (g) (range 1000-1720). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg. Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sedat Dalbayrak ◽  
Onur Yaman ◽  
Kadir Öztürk ◽  
Mesut Yılmaz ◽  
Mahmut Gökdağ ◽  
...  

Objective. Many surgical approaches have been defined and implemented in the last few decades for thoracic disc herniations. The endoscopic foraminal approach in foraminal, lateral, and far lateral disc hernias is a contemporary minimal invasive approach. This study was performed to show that the approach is possible using the microscope without an endoscope, and even the intervention on the discs within the spinal canal is possible by having access through the foramen.Methods.Forty-two cases with disc hernias in the medial of the pedicle were included in this study; surgeries were performed with transforaminal approach and microsurgically. Extraforaminal disc hernias were not included in the study. Access was made through the Kambin triangle, foramen was enlarged, and spinal canal was entered.Results.The procedure took 65 minutes in the average, and the mean bleeding amount was about 100cc. They were mobilized within the same day postoperatively. No complications were seen. Follow-up periods range between 5 and 84 months, and the mean follow-up period is 30.2 months.Conclusion.Transforaminal microdiscectomy is a method that can be performed in any clinic with standard spinal surgery equipment. It does not require additional equipment or high costs.


2018 ◽  
Vol 66 (07) ◽  
pp. 589-594 ◽  
Author(s):  
Celalettin Kocaturk ◽  
Hasan Akin ◽  
Sertan Erdogan ◽  
Salih Bilen ◽  
Kemal Karapinar ◽  
...  

Objective Video-assisted thoracoscopic surgery (VATS) has become the standard treatment method for primary spontaneous pneumothorax. Concerns about lesser pain and better cosmesis led to the evolution of uniportal access. This study prospectively compared the results of the uniportal, two-port, and three-port thoracoscopic surgery. Material and Methods One hundred and thirty-five patients were randomized into three groups according to the port numbers. The groups were compared regarding the operation time, hospital stay, amount of drainage, area of pleurectomy, complications, recurrences, and pain scores. Results Except for the amount of drainage (p = 0.03), no factors were found to be statistically significant. The overall recurrence rate was 5%. Although the first and second week pain scores were not statistically significant, the single-incision group patients had significantly less pain at 4, 24, and 72 hours (p < 0.05). Conclusion The study indicated that uniportal VATS approach is less painful and has better cosmetic results, besides it is as efficient as two- or three-port VATS approach.


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